Health

Leading UK burns unit 'matches best in world for survival'

A major burns unit in Essex has reported dramatic improvements in survival rates, placing it on a par with the best in the world.

The progress, published in the Journal of Trauma, is particularly marked in children and young people.

St Andrew's Centre for Plastic Surgery and Burns in Chelmsford says the figures reflect advances in surgery and intensive care.

The British Burn Association says the findings are "exciting".

The Chelmsford burn service is one of several regional centres across the UK. It treats about three out of four major burns patients requiring intensive care in London and south east England.

An audit of survival rates at the unit going back to the early 1980s has been published in the Journal of Trauma.

The most dramatic progress is in children and young adults. In the 1980s they would typically have had a 50:50 chance of surviving a severe burn across half the body.

Now for children the odds are the same with for those with almost 100% burns.

Image caption Alfred Page experienced severe burns aged 12

Remove dead tissue

The centre's clinical director, Peter Dziewulski, says lessons he picked up while working in Texas have saved lives in the UK.

"We have an aphorism here that removing dead tissue saves lives. And by being aggressive, removing dead, burnt tissue, and looking after patients with intensive care techniques we've found that this has been one of the key elements in keeping people alive."

Burnt tissue is very susceptible to infection. The priority at St Andrews is to take it out within 24 hours, while providing intensive care inside the operating theatre to minimise the risks.

Prof Dziewulski - a member of the British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS) - says this fast response demands consultant-led care on the spot, round the clock and at weekends.

The whole process, including treatment and rehabilitation is labour intensive. It requires careful coordination between surgeons, intensive care doctors, anaesthetists, paediatricians, specialist nurses, physios, and occupational therapists.

Alfred Page was 12 when he he was first brought in more than a decade ago with full thickness burns across 75% of his body. He'd been doused with petrol and set alight.

Now he is back in the burns unit for a further skin graft on his back - because his body has grown. He feels enormous gratitude for staff here, despite the painful memories.

"It didn't actually register that I was burnt until I went home and I stayed at my Nan's. Then I walked past a big mirror one day and saw the scarring."

Alfred, from Gillingham in Kent, is a success story. He's married with a little girl - and enjoys taking his family out on his boat.

"After I found out I had really bad scarring I thought it's going to be really hard to make friends again.

"But all my old friends were still there. And I never thought I'd meet more friends through being burnt but I know quite a few people who are burnt themselves, and they all look at life in the same way as I do."

Other regional burns centres in the UK are adopting the model of care developed at Chelmsford.

Remo Papini from the British Burn Association, who is a consultant plastic surgeon in Birmingham, says there has been a lot of progress in recent years.

"It's very exciting. It's encouraging that we can produce similar results to much better resourced units in the States.

"And clearly Chelmsford have taken that model and produced equally good results over here. And it's a testament to their dedication and their perseverance with this - and their skill."

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